Age-related maculopathy (ARM), a common degeneration of the retina, is added to the list of chronic conditions of aging that may be affected by suboptimal nutrition. We propose to conduct an epidemiologic investigation to evaluate relationships of nutritional factors to ARM in two large datasets. This research addresses relationships of under- and overnutrition in older adults to this common chronic condition of aging, and therefore relates to research requested in Program Announcement PA-94-088 entitled """"""""Malnutrition in Older Persons."""""""" The unique opportunity to conduct this research was made possible by recently obtained photographic data to evaluate ARM in two large population-based samples for which nutritional data are also available. In the first dataset, associations between the prevalence of ARM (determined from retinal photographs), nutrients in the diet (assessed from diet recalls and responses to food frequency and vitamin supplement questionnaires), and serum in the Third National Health and Nutrition Examination Survey (NHANES III) sample of persons 40 years of age and older (approximately 8.000 people) will be evaluated. This investigation will permit evaluation of these associations in the United States population overall, and in subgroups defined by age, race, geographic location, and presence of other potential risk factors (smoking, estrogen use, cardiovascular disease). In the second dataset, relationships of dietary factors to ARM will be studied in a large prospective study cohort in four United States communities, ascertained for the Atherosclerosis Risk in Communities (ARIC) study (n=11,247). Associations between the prevalence of ARM (also determined from retinal photographs) and diet (determined six years earlier), will be evaluated. Consistency of findings between the two population groups will support the hypothesis of causal relations between diet and ARM. This research 'will also provide the first available evaluation of relationships of nutritional factors to ARM in non-Hispanic Whites, non-Hispanic Blacks and Mexican Americans in NHINES III and in Whites and Blacks participating in the ARIC study. Confirmation of suspected relationships of nutritional factors to ARM in the United States population and population subgroups will provide the impetus to evaluate specific nutritional interventions in future prevention trials.
